Frozen shoulder had no standard definition, making cross-study comparison impossible. This survey asked 211 ASES shoulder specialists to endorse a proposed definition and a primary/secondary classification system. Secondary frozen shoulder was further divided into intrinsic, extrinsic, and systemic subtypes.
When you see a stiff, painful shoulder, the first discriminator is passive motion. Frozen shoulder restricts both active AND passive glenohumeral motion with essentially normal radiographs. A rotator cuff tear typically limits active motion while passive motion is preserved.
The next step is deciding primary versus secondary. Primary (idiopathic) has no identifiable cause. Secondary means you can point to a driver, which changes management because you must treat the underlying condition.
Use the three secondary buckets as a checklist: intrinsic (cuff, biceps, calcific tendonitis), extrinsic (breast surgery, cervical radiculopathy, prior CVA, chest wall pathology), and systemic (diabetes, thyroid disease). Screening for diabetes and thyroid dysfunction is worthwhile in any frozen shoulder.
The value of this paper is a shared vocabulary. The 66% agreement on the secondary subtypes tells you that piece remains debated, so document your specific findings rather than relying on the label alone.
Frozen shoulder had no standard definition, making cross-study comparison impossible. This survey asked 211 ASES shoulder specialists to endorse a proposed definition and a primary/secondary classification system. Secondary frozen shoulder was further divided into intrinsic, extrinsic, and systemic subtypes.
When you see a stiff, painful shoulder, the first discriminator is passive motion. Frozen shoulder restricts both active AND passive glenohumeral motion with essentially normal radiographs. A rotator cuff tear typically limits active motion while passive motion is preserved.
The next step is deciding primary versus secondary. Primary (idiopathic) has no identifiable cause. Secondary means you can point to a driver, which changes management because you must treat the underlying condition.
Use the three secondary buckets as a checklist: intrinsic (cuff, biceps, calcific tendonitis), extrinsic (breast surgery, cervical radiculopathy, prior CVA, chest wall pathology), and systemic (diabetes, thyroid disease). Screening for diabetes and thyroid dysfunction is worthwhile in any frozen shoulder.
The value of this paper is a shared vocabulary. The 66% agreement on the secondary subtypes tells you that piece remains debated, so document your specific findings rather than relying on the label alone.